BOSTON -- Younger doctors may be slightly less sold on childhood vaccination than their older counterparts, a researcher said here.

Action Points

Explain that the value of childhood vaccination is less apparent to younger doctors than to their older counterparts although the vast majority of doctors remained highly supportive, with nearly 90% agreeing that vaccines are getting better and safer.

Point out that younger doctors were significantly more likely to question the safety of vaccines against polio (both inactivated and oral), varicella, and measles/mumps/rubella.

BOSTON -- The value of childhood vaccination is less apparent to younger doctors than to their older counterparts, a researcher said here.

In a cross-sectional survey of 551 healthcare providers, more recent graduates were less likely to think that vaccines were efficacious, according to Saad Omer, MBBS, PhD, of Emory University in Atlanta.

They were also more likely to have doubts about the safety of some vaccines, Omer told reporters at the annual meeting of the Infectious Diseases Society of America.

Overall, however, the physicians who took part in the survey remained highly supportive of childhood vaccines, Omer told MedPage Today, with nearly 90% agreeing that vaccines are getting better and safer.

"What we picked up were relative differences – relative, subtle, but important differences," he said.

The findings are significant because doctors are one of the most powerful influences on parental decisions about vaccination, he said.

They signal "a potentially important change in immunization beliefs in the new generation of providers, compared with their older counterparts," he and co-author Michelle Mergler, MHS, of Johns Hopkins Bloomberg School of Public Health, argued in their poster presentation.

"For a long time, we've suspected this kind of thing," commented Bruce Gellin, MD, director of the National Vaccine Program Office in Washington, who was not involved in the study but who moderated a press conference at which some details were presented.

"As familiarity with the disease goes away, they're only hearing about the vaccine and don't often link up with what the vaccines are designed to do," Gellin said. "In some ways this mimics the situation in society at large, where young parents are not familiar with these diseases."

"This tells us where we need to focus our efforts," he added.

The researchers questioned healthcare providers identified by a cohort of parents in Colorado, Massachusetts, Missouri, and Washington whose children were either fully vaccinated or exempt from one or more school immunization requirements.

All told, 84.3% of the doctors answered the questionnaire, which asked for their views on the risk of a range of vaccine-preventable diseases, including polio and influenza, and their opinions on the efficacy and safety of vaccines against them.

The researchers stratified the participants into five-year blocks, depending on the year they graduated from medical school, and used logistic regression methods to look for associations between beliefs and time since beginning practice.

They found:

Most doctors – 81.2% -- agreed that vaccines are one of the safest forms of medicine ever developed, and 89.1% thought that they were getting both safer and more effective.

In both cases, each increase of five years in the year of graduation was associated with 20% decrease in the odds of a doctor believing the statements were true. (The odds ratio was 0.80 for both, with 95% confidence intervals from 0.7 to 0.9 and 0.7 to 1.0, respectively.)

Each increase of five years in the year of graduation was also associated with a significant 18% reduction in the odds that a doctor would believe in high vaccine efficacy overall.

Although there was a similar reduction in the belief in safety, it did not reach significance overall.

However, younger doctors were significantly more likely to question the safety of vaccines against polio (both inactivated and oral), varicella, and measles/mumps/rubella.

In one way, Omer said, the finding may be a result of the very success of vaccination programs. "With such a low burden of disease, the efficacy and real or perceived side effects of vaccines may be the most significant factors contributing to vaccination behaviors," he and Mergler argued.

The researchers did not report external support for the study. They said they had no disclosures.

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